CURRICULUM VITAEkonkerpdpi2019.com/download/materi_ws/workshop_7/day_1/1_Introduction... · edukasi...
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CURRICULUM VITAE • Nama Lengkap : dr. Tri Wahju Astuti,MKes,Sp.P(K) • Tempat & Tanggal Lahir : Jember, 22 Oktober 1963 • Alamat : Jl. Danau Sentani Utara H2A-31 Malang • No. Tlp/Fax/HP : (0341) 712655 / 08123297361 • Alamat Kantor : SMF Paru RSU Dr. Saiful Anwar, Jl. Jagung Suprapto No 2 Malang • Pendidikan Dokter umum : FK Unibraw tahun 1989 Magister : FK Unair tahun 1997 Spesialis Paru : FK Unibraw tahun 2008 Konsultan Paru Kerja & Lingkungan : Kolegium Pulmonologi 2012 • Riwayat Pekerjaan/Pengalaman Puskesmas Sukajaya – Bogor: 1990 - 1992 Puskesmas Pasirlangu – Bandung : 1992 - 1995 Dosen FKUB : 1996 – sekarang Penyelia Pusat UKMPPD : 2013 - sekarang Ketua Program Studi Pendidikan Dokter : 2016 – Sekarang • Organisasi Profesi Persatuan Dokter Paru Indonesia Cabang Malang Ikatan Dokter Indonesia Asian Pacific Society of Respirology
Introduction of
Workplace-Based Assessment
Tri Wahju astuti
BACKGROUND
Competence: what an individual is able to do in clinical practice
Performance: what an individual actually does in clinical practice
Dimensions of medical competence including:
−The scientific knowledge base
−Professional practice elements: history taking, communication, physical examination, procedural and management skills, problem solving ability, relationships with colleagues & ethical behaviour
Peran Lulusan Dokter Spesialis Pulmonologi & Kedokteran Respirasi
Kepakaran Klinik
(Clinical Expertise
Memperlihatkan keterampilan diagnostik &
terapeutik dlm tatalaksana yg efektif
& etis pd px.
Mencari & mengikuti kemajuan informasi yg tepat & relevan u/
praktik klinik.
Memberikan pelayanan konsultatif
yg efektif sehubungan dengan tatalaksana pasien, edukasi & pendapat
legal.
Komunikator
Membina hubungan dgn px & sejawat dlm rangka
pengobatan px. Menghasilkan & mensintesis riwayat penyakit yg relevan
dari px / kolega / lingkungan , dgn mendengar &
melakukan wawancara yg efektif.
Memberikan informasi yg sesuai kpd px / tim
keluarga & tim pelayanan. Mampu mengembangkan
kemampuan berkomunikasi dengan
unsur-unsur yg bertugas di rawat inap & rawat
jalan.
Berkonsultasi efektif dengan dokter2 & profesi
kesehatan lain.
• Memberikan kontribusi yang efektif terhadap kegiatan-kegiatan tim interdisiplin
Kemampuan Bekerjasama (kolaborator)
Berkonsultasi dengan efektif dengan dokter-
dokter dan profesi kesehatan lain.
Memberikan kontribusi yang efektif terhadap
kegiatan-kegiatan tim interdisiplin
Manajer
Menggunakan & memanfaatkan
sumber daya scr efektif guna perawatan px, kebutuhan belajar,
& aktifitas diluar, secara seimbang.
Mengalokasikan sarana pemeliharaan
kesehatan yg terbatas secara bijaksana.
Bekerja secara efektif & efisien dalam suatu organisasi kesehatan.
Menggunakan TI u/ mengoptimalkan tatalaksana px,
pembelajaran yg berkesinambungan &
kegiatan2 lain
Advokator Kesehatan
Mengidentifikasi determinan
kesehatan yg penting yg mempengaruhi px.
Memberikan kontribusi yang
efektif untuk memperbaiki
kesehatan pasien dan masyarakat.
Mengenal dan menjawab
permasalahan dimana advokasi
tepat untuk dilaksanakan.
Ilmuwan (scholar)
Mengembangkan, mengimplementasikan dan memantau strategi pendidikan untuk diri
sendiri yang berkelanjutan.
Menilai secara kritis sumber-sumber informasi medik.
Memfasilitasi pembelajaran pasien,
mahasiswa kedokteran dan tenaga professional
lain.
Berkontribusi terhadap pengembangan ilmu
baru.
Professional
Memberikan pelayanan yang bermutu tinggi
dengan integritas, kejujuran, dan rasa
kasih.
Memperlihatkan perilaku personal dan interpersonal
yang baik.
Menjalankan praktik kedokteran yang etis
dan sesuai dengan kewajiban seorang
dokter
Learning Stages for Complex Cognitive Skills
1. Novice: rigid adherence to rules; poor situational perception; no experience
2. Advanced beginner: uses guidelines for action, still limited situational perception
3. Competent: better view of big picture; plans ahead; but still procedure driven
4. Proficient: holistic view and able to extract most important elements of situation; uses maxims (generalizable)
5. Expert: no longer relies on rules, guidelines or maxims; intuitive grasp and recognition of patterns for ease of decision action
Dryfus & Dryfus (1980)
Learning Domains
Cognitive: intellectual skills (facts, procedures, concepts, rules, principles)
Psychomotor: complex perceptual – motor skills
Affective: emotional control, stress – coping, attitudinal predisposition to respond
Learning Stages For Complex Perceptual Motor Learning
Cognitive: knowledge based (thinking, verbal) understanding of task and strategies
Associative: procedural (rule-based) understanding of steps or task sequence
Autonomous: (unconscious) automatic execution of skilled performance with high accuracy and precision
Fittsand Posner (1967)
Kurikulum Pendidikan Dokter Spesialis Pulmonologi & Kedokteran Respirasi
CAPAIAN PEMBELAJARAN
(LEARNING OUTCOME)
Kerangka Kualifikasi Nasional Indonesia (KKNI)
UU Pendidikan Kedokteran
(no.20/th/2013)
Standar Nasional
Pendidikan Tinggi
Standar Nasional Pendidikan Kedokteran 2018
WFME , ACGME, Global
Standards for Quality
Improvement
Standar Kompetensi
Dokter Spesialis Pulmonologi &
Kedokteran Respirasi
RENCANA PEMBELAJARAN
KURIKULUM
MAKROKURIKULUM (Peta Kurikulum; ,kompetensi disease, ketrampilan klinis)
MESOKURIKULUM (Tahapan per tahun, Divisi, Mata Ajar)
MIKROKURIKULUM (Rencana Pembelajaran Semester (RPS) per divisi per mata ajar
TUJUAN PEMBELAJARAN
Disusun per Divisi per mata ajar dalam bentuk Rencana Pembelajaran
Didasarkan pada level capaian
dalam SK DSPKR
Menjadi landasan untuk
asesmen/evaluasi belajar (blueprint)
METODE PEMBELAJARAN
Pemilihan metode pembelajaran
disesuaikan dengan tujuan pembelajaran
KOGNITIF : Diskusi ; Problem
based learning (PBL); POMR
PSIKOMOTOR : Clinical skills training (Skills lab); procedural skills; project
based learning
Profesionalism / attitude
EVALUASI PEMBELAJARAN
Menilai ketercapaian tujuan belajar
(blueprint assessment)
Evaluasi proses belajar
WFME Standard 3 (revised)
13
Does
Shows how
Knows how
Knows
Cognition
Behaviour
Miller’s pyramid: a framework for assessing clinical competence
Performance-based
testing: 360 degree,
Portfolio, Mini-CEX
Competency-based
testing: OSCE, Short
case, long case
Clinical contact-based
testing: MEQ, EMQ,
PMPs, SAQ, SEQ
Factual testing: MCQ,
Essay, Oral
Miller’s Model of Clinical Competence
Performance assessment: the assessment of skills & behaviour, both in academic & workplace setting
Performance assessment: building in a degree of complexity to Miller’s pyramid, recognising both the development of performance expertise, & the need for skills & behaviour maintenance through deliberate practice.
Through the skills complexity triangle, some of the contextual factors which impact on performance measures, both individual & systems related, including taking experience into account.
Miller’s Model of Performance Assessment
Deliberate practice Integrated
team performance
Integrated skills
Task training
Does
Shows how
Knows how
Knows
Cognitive phase
Integrative phase
Skills complexity triangle
Miller Fitts and Posner
Ericsson
ASSESSMENT
Integrated assessment 3 components:
Applied knowledge test (AKT)
Clinical skill assessment (CSA)
Workplace-based assessment (WPBA)
Each of these components is assessed independently and will assess different skills, but together the 3 components will cover the curriculum.
Knowledge is only one aspect of being a doctor how about competencies & performance in the professional practice?
Competencies can be assessed through relevant clinical tasks were often simulated & occasionally distant from the workplace
Assessment of competence – performance misses routine behavior
WPBA tools assess at the “does” level of Miller’s pyramid
WORKPLACE-BASED ASSESSMENT (WPBA)
Definition of WPBA
A form of authentic assessment testing of performance in the real environment facing doctors in their everyday clinical practice
Boursicot K, Etherridge L, et al. 2010
Assessment of day to day working practices undertaken in the working environment
PMETB Workplace – Based Assessment January 2005
The evaluation of a doctor’s performace progress over time in professional practice areas best tested in the
workplace http://www.1scp.ac.uk/Assessment/WBA/Intro.aspx
Structured & continuous: not only to form judgement on competence
Repeated assessment assessor has the opportunity for gathering documentary evidence of the student’s actual performace progression
Can identify gaps in practice allow the assessor & student to mutually plan student development needs
Helps identify difficulties, strength & weakness of student in different areas of practice e.g. technical skills, professional behaviour & teamworking
Reasons for using WPBA
Best assessment practice in medical education rather than traditional assessment allow the assessment of professional behavior aspects
Allows the assessment to get as close as possible to the real situations in which doctors work
Based on contemporary educational design
Drive learning in important areas of competency
Reasons for using WPBA.....
Assessment tools for clinical competence
Objective structure clinical examination OSCE
Objective structured long case examination record
OSLER
Objective structured assessment of technical skills
OSATS
These are undertaken outside the “real” clinical environment but have many aspects of realism of workplace incorporate into them and are assessed at the “shows how” level of Miller’s pyramid.
Mini clinical evaluation exercise Mini-CEX
Direct observation procedural skills DOPS
Case-based discussion CbD
Mini-peer assessment technique Mini-PAT
Assessment tools for clinical performance
Consultation Observation Tool COT
Patient Satisfaction Questionnaire PSQ
CWS Clinical Work Sampling